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1.
Ecol Lett ; 27(9): e14527, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39354905

ABSTRACT

In tropical forests, trees strategically balance growth patterns to optimise fitness amid multiple environmental stressors. Wind poses the primary risk to a tree's mechanical stability, prompting developments such as thicker trunks to withstand the bending forces. Therefore, a trade-off in resource allocation exists between diameter growth and vertical growth to compete for light. We explore this trade-off by measuring the relative wind mortality risk for 95 trees in a tropical forest in Panama and testing how it varies with tree size, species and wind exposure. Surprisingly, local wind exposure and tree size had minimal impact on wind mortality risk; instead, species wood density emerged as the crucial factor. Low wood density species exhibited a significantly greater wind mortality risk, suggesting a prioritisation of competition for light over biomechanical stability. Our study highlights the pivotal role of wind safety in shaping the life-history strategy of trees and structuring diverse tropical forests.


Subject(s)
Forests , Trees , Tropical Climate , Wind , Trees/growth & development , Panama , Wood
2.
Am J Clin Nutr ; 120 Suppl 1: S15-S30, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39300660

ABSTRACT

BACKGROUND: Environmental enteric dysfunction (EED) is an asymptomatic intestinal disorder associated with growth impairment, delayed neurocognitive development, and impaired oral vaccine responses. OBJECTIVES: We set out to develop and validate a histopathologic scoring system on duodenal biopsies from a cohort study of children with growth failure in Bangladesh, Pakistan, and Zambia ("EED") with reference to biopsies from United States children with no clinically reported histologic pathology (referred to hereafter as "normal") or celiac disease. METHODS: Five gastrointestinal pathologists evaluated 745 hematoxylin and eosin slide images from 291 children with EED (mean age: 1.6 y) and 66 United States children (mean age: 6.8 y). Histomorphologic features (i.e., villus/crypt architecture, goblet cells, epithelial and lamina propria acute/chronic inflammation, Brunner's glands, Paneth cells, epithelial detachment, enterocyte injury, and foveolar metaplasia) were used to score each histopathologic slide. Generalized estimating equations were used to determine differences between EED, normal, and celiac disease, and receiver operating characteristic curves were used to assess predictive value. RESULTS: Biopsies from the duodenal bulb showed higher intramucosal Brunner's gland scores and lower intraepithelial lymphocyte scores than from the second or third parts of the duodenum (D2/3), so only D2/3 were included in the final analysis. Although 7 parameters differed significantly between EED and normal biopsies in regression models, only 5 (blunted villus architecture, increased intraepithelial lymphocytosis, goblet cell depletion, Paneth cell depletion, and reduced intramucosal Brunner's glands) were required to create a total score percentage (TSP-5) that correctly identified EED against normal biopsies (AUC: 0.992; 95% CI: 0.983, 0.998). Geographic comparisons showed more severe goblet cell depletion in Bangladesh and more marked intraepithelial lymphocytosis in Pakistan. CONCLUSIONS: This scoring system involving 5 histologic parameters demonstrates very high discrimination between EED and normal biopsies, indicating that this scoring system can be applied with confidence to studies of intestinal biopsies in EED.


Subject(s)
Duodenum , Humans , Bangladesh/epidemiology , Pakistan/epidemiology , Zambia/epidemiology , Cohort Studies , Child , Female , Male , Infant , Child, Preschool , Duodenum/pathology , United States/epidemiology , Biopsy , Intestinal Diseases/pathology , Celiac Disease/pathology , Intestinal Mucosa/pathology , Goblet Cells/pathology , Child Nutrition Disorders/epidemiology , Child Nutrition Disorders/pathology
3.
Am J Clin Nutr ; 120 Suppl 1: S51-S64, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39300663

ABSTRACT

BACKGROUND: Environmental enteric dysfunction (EED) is an inflammatory condition of the small intestine that is prevalent in children residing in low- and middle-income countries. EED is accompanied by profound histopathologic changes in the small bowel, loss of absorptive capacity, increased intestinal permeability, increased microbial translocation, and nutrient loss. OBJECTIVES: We sought to identify dysregulated genes and pathways that might underlie pediatric EED. METHODS: RNA-sequencing libraries were generated from endoscopically obtained duodenal tissue from undernourished children with EED from 3 prospective cohorts of children with EED. The EED transcriptome was defined in comparison to North American children without EED. Weighted gene coexpression network analysis (WGCNA) was tested for gene modules associated with EED and its histologic features. RESULTS: The 1784 upregulated genes in EED were highly enriched for immune and inflammatory processes, including IL-17 and JAK-STAT signaling, and cytokine-cytokine receptor interactions. The 1388 downregulated genes included genes corresponding to xenobiotic metabolism, detoxification, and antioxidant capacities. A gene coexpression module enriched for antimicrobial responses and chemokine activity was significantly associated with villous blunting, goblet cell depletion, and overall histologic severity of EED. CONCLUSIONS: The transcriptome signatures of EED include specific innate and adaptive immune responses that are consistently elevated across study centers, coupled with reduced detoxification and antioxidant capacities. These data may have implications for targeted interventions to improve EED outcomes.


Subject(s)
Duodenum , Inflammation , Transcriptome , Humans , Duodenum/metabolism , Duodenum/immunology , Duodenum/pathology , Child, Preschool , Male , Female , Child , Inflammation/genetics , Infant , Prospective Studies
4.
Am J Clin Nutr ; 120 Suppl 1: S73-S83, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39300665

ABSTRACT

BACKGROUND: Validated biomarkers could catalyze environmental enteric dysfunction (EED) research. OBJECTIVES: Leveraging an EED histology scoring system, this multicountry analysis examined biomarker associations with duodenal histology features among children with EED. We also examined differences in 2-h compared with 1-h urine collections in the lactulose rhamnose (LR) dual sugar test. METHODS: Three cohorts of undernourished children unresponsive to nutrition intervention underwent esophagogastroduodenoscopy and duodenal biopsies. Histopathology scores were compared to fecal calprotectin (CAL), myeloperoxidase (MPO), neopterin (NEO), and urinary LR ratio and lactulose percentage recovery. Log-transformed biomarkers were used in linear regressions adjusted for age, center, and sample collection-biopsy time interval in multivariable models. RESULTS: Data on >1 biomarker were available for 120 Bangladeshi (CAL, MPO, NEO, and LR), 63 Pakistani (MPO, NEO, and LR), and 63 Zambian children (CAL). Median age at endoscopy was similar (19 mo) across centers. Median sample collection prior to endoscopy was consistent with each center's study design: 2 wk in Bangladesh (urine and stool) and Zambia (stool), and 6 (urine) and 11 (stool) mo in Pakistan. In multivariable models, intraepithelial lymphocytes were associated with CAL (exponentiated [exp.] coefficient: 1.19; 95% confidence interval [CI]: 1, 1.41), intramucosal Brunner's glands with MPO (exp. coefficient: 1.33; 95% CI: 1.05, 1.69) and NEO (exp. coefficient: 1.37; 95% CI: 1.1, 1.7), and chronic inflammation with NEO (exp. coefficient: 1.61; 95% CI: 1.17, 2.17). Intraepithelial lymphocytes were associated with lactulose % recovery (exp. coefficient: 1.22; 95% CI: 1.05, 1.41). LR recovery was substantially lower in 1-h collections than in 2-h collections. CONCLUSIONS: Four commonly used markers of enteric dysfunction were associated with specific histologic features. One-hour urine collection may be insufficient to reflect small bowel permeability in LR testing. While acknowledging the challenges with obtaining relevant tissue, these findings form the basis for further EED biomarker validation research.


Subject(s)
Biomarkers , Humans , Biomarkers/urine , Female , Male , Infant , Cohort Studies , Child, Preschool , Feces/chemistry , Intestine, Small/pathology , Lactulose/urine , Child Nutrition Disorders/pathology , Bangladesh , Leukocyte L1 Antigen Complex/analysis , Zambia , Neopterin/urine , Peroxidase/metabolism , Malnutrition
5.
Glob Chang Biol ; 30(9): e17493, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39239723

ABSTRACT

The future of tropical forests hinges on the balance between disturbance rates, which are expected to increase with climate change, and tree growth. Whereas tree growth is a slow process, disturbance events occur sporadically and tend to be short-lived. This difference challenges forest monitoring to achieve sufficient resolution to capture tree growth, while covering the necessary scale to characterize disturbance rates. Airborne LiDAR time series can address this challenge by measuring landscape scale changes in canopy height at 1 m resolution. In this study, we present a robust framework for analysing disturbance and recovery processes in LiDAR time series data. We apply this framework to 8000 ha of old-growth tropical forests over a 4-5-year time frame, comparing growth and disturbance rates between Borneo, the eastern Amazon and the Guiana shield. Our findings reveal that disturbance was balanced by growth in eastern Amazonia and the Guiana shield, resulting in a relatively stable mean canopy height. In contrast, tall Bornean forests experienced a decrease in canopy height due to numerous small-scale (<0.1 ha) disturbance events outweighing the gains due to growth. Within sites, we found that disturbance rates were weakly related to topography, but significantly increased with maximum canopy height. This could be because taller trees were particularly vulnerable to disturbance agents such as drought, wind and lightning. Consequently, we anticipate that tall forests, which contain substantial carbon stocks, will be disproportionately affected by the increasing severity of extreme weather events driven by climate change.


Subject(s)
Climate Change , Forests , Trees , Trees/growth & development , Borneo , Tropical Climate , Brazil
6.
Am J Surg Pathol ; 48(10): 1270-1276, 2024 Oct 01.
Article in English | MEDLINE | ID: mdl-38992873

ABSTRACT

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of the skin. Risk factors include extensive sun damage, infection with Merkel cell polyomavirus, and an immunocompromised state. PRAME, also known as preferentially expressed antigen in melanoma, is a cancer-testis antigen recently found to be a useful diagnostic tool in the workup of melanocytic neoplasms. However, the expression pattern of PRAME in Merkel cell carcinoma is unknown. In this study, we examine PRAME expression in Merkel cell carcinoma and explore its prognostic implications. The institutional archives at the University of Virginia were used to search for tumors classified as Merkel cell carcinoma from 2004 to 2022. All potential cases were reviewed to confirm the diagnosis, and electronic medical records were searched for clinical and demographic data. Tumors were subsequently immunostained for PRAME and Merkel cell polyomavirus. Cox proportional hazards regression models were used to estimate relative (all-cause) survival of PRAME positivity and MCPyV positivity in our study as well as MCC-specific survival of PRAME positivity. Univariate and multivariable models were created for each outcome related to all-cause survival. A total of 39 cases were included in the study. Twenty-eight percent (11 cases) demonstrated strong PRAME expression, and 27% of cases were positive for Merkel cell polyomavirus. There was no statistically significant correlation between PRAME expression and virus positivity. With respect to PRAME, the adjusted all-cause mortality hazard ratio was 11.4 (95% CI: 1.8, 70.8). The unadjusted MCC-specific hazard ratio was 4.6 (95% CI: 0.8, 27.5). The adjusted hazard ratio pertaining to Merkel cell polyomavirus infection was 0.25 (95% CI: 0.02, 2.96). In this limited cohort, PRAME expression appears to correlate with worse outcomes in Merkel cell carcinoma.


Subject(s)
Biomarkers, Tumor , Carcinoma, Merkel Cell , Merkel cell polyomavirus , Skin Neoplasms , Carcinoma, Merkel Cell/virology , Carcinoma, Merkel Cell/pathology , Carcinoma, Merkel Cell/mortality , Humans , Male , Skin Neoplasms/virology , Skin Neoplasms/pathology , Skin Neoplasms/mortality , Female , Aged , Biomarkers, Tumor/analysis , Middle Aged , Aged, 80 and over , Merkel cell polyomavirus/isolation & purification , Retrospective Studies , Immunohistochemistry , Antigens, Viral, Tumor/analysis , Prognosis , Polyomavirus Infections/virology , Polyomavirus Infections/pathology , Polyomavirus Infections/mortality , Antigens, Neoplasm
7.
Sex Transm Dis ; 2024 Jul 24.
Article in English | MEDLINE | ID: mdl-39046156

ABSTRACT

BACKGROUND: Chlamydia trachomatis (CT) acquired orally may survive passage through the gastrointestinal tract and establish an infection in the rectum, but how often this occurs is unknown. METHODS: In 2019-2022 we enrolled individuals assigned male at birth who reported sex with men and denied receptive anal sex in the past 2 years. Participants enrolled at the Seattle Sexual Health Clinic or online. Participants completed a behavioral survey and self-collected rectal swabs for CT nucleic acid amplification testing (NAAT) and culture and viability PCR (vPCR). We defined oral exposures as fellatio, cunnilingus, and oral-anal (i.e., rimming). RESULTS: We enrolled 275 men; 60 (22%) reported only oral exposures in the past 12 months. Of these, five (8.3%) tested positive for rectal CT by NAAT; 1 (2%) had viable CT detected (culture-positive; vPCR-positive). Another 43 participants reported only oral exposures in the past 2 months but rectal exposures 3-12 months ago. Of these, 4 (9%) tested NAAT-positive for rectal CT; 1 had viable CT detected (culture-negative; vPCR-positive). CONCLUSIONS: Passage of CT from the mouth to the rectum occurs, but is most often nucleic acid remnants rather than viable bacteria. Nonetheless, it appears possible to establish a viable rectal CT infection via oral exposures.

8.
Am J Clin Nutr ; 120 Suppl 1: S41-S50, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38685382

ABSTRACT

BACKGROUND: Environmental enteric dysfunction (EED), a chronic inflammatory condition of the small intestine, is an important driver of childhood malnutrition globally. Quantifying intestinal morphology in EED allows for exploration of its association with functional and disease outcomes. OBJECTIVES: We sought to define morphometric characteristics of childhood EED and determine whether morphology features were associated with disease pathophysiology. METHODS: Morphometric measurements and histology were assessed on duodenal biopsy slides for this cross-sectional study from children with EED in Bangladesh, Pakistan, and Zambia (n = 69), and those with no pathologic abnormality (NPA; n = 8) or celiac disease (n = 18) in North America. Immunohistochemistry was also conducted on 46, 8, and 18 biopsy slides, respectively. Linear mixed-effects regression models were used to reveal morphometric differences between EED compared with NPA or celiac disease and identify associations between morphometry and histology or immunohistochemistry among children with EED. RESULTS: In duodenal biopsies, median EED villus height (248 µm), crypt depth (299 µm), and villus:crypt (V:C) ratio (0.9) values ranged between those of NPA (396 µm villus height; 246 µm crypt depth; 1.6 V:C ratio) and celiac disease (208 µm villus height; 365 µm crypt depth; 0.5 V:C ratio). Among EED biopsy slides, morphometric assessments were not associated with histologic parameters or immunohistochemical markers, other than pathologist-determined subjective semiquantitative villus architecture. CONCLUSIONS: Morphometric analysis of duodenal biopsy slides across geographies identified morphologic features of EED, specifically short villi, elongated crypts, and a smaller V:C ratio relative to NPA slides, although not as severe as in celiac slides. Morphometry did not explain other EED features, suggesting that EED histopathologic processes may be operating independently of morphology. Although acknowledging the challenges with obtaining relevant tissue, these data form the basis for further assessments of the role of morphometry in EED.


Subject(s)
Duodenum , Intestinal Mucosa , Humans , Cross-Sectional Studies , Duodenum/pathology , Male , Female , Child, Preschool , Intestinal Mucosa/pathology , Zambia , Child , Celiac Disease/pathology , Infant , Bangladesh , Pakistan , Biopsy
11.
Nature ; 620(7975): 807-812, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37612395

ABSTRACT

The United Nations recently agreed to major expansions of global protected areas (PAs) to slow biodiversity declines1. However, although reserves often reduce habitat loss, their efficacy at preserving animal diversity and their influence on biodiversity in surrounding unprotected areas remain unclear2-5. Unregulated hunting can empty PAs of large animals6, illegal tree felling can degrade habitat quality7, and parks can simply displace disturbances such as logging and hunting to unprotected areas of the landscape8 (a phenomenon called leakage). Alternatively, well-functioning PAs could enhance animal diversity within reserves as well as in nearby unprotected sites9 (an effect called spillover). Here we test whether PAs across mega-diverse Southeast Asia contribute to vertebrate conservation inside and outside their boundaries. Reserves increased all facets of bird diversity. Large reserves were also associated with substantially enhanced mammal diversity in the adjacent unprotected landscape. Rather than PAs generating leakage that deteriorated ecological conditions elsewhere, our results are consistent with PAs inducing spillover that benefits biodiversity in surrounding areas. These findings support the United Nations goal of achieving 30% PA coverage by 2030 by demonstrating that PAs are associated with higher vertebrate diversity both inside their boundaries and in the broader landscape.


Subject(s)
Biodiversity , Conservation of Natural Resources , Goals , Tropical Climate , United Nations , Animals , Conservation of Natural Resources/legislation & jurisprudence , Conservation of Natural Resources/methods , Conservation of Natural Resources/trends , Mammals , Forestry/legislation & jurisprudence , Forestry/methods , Forestry/trends
12.
Nat Ecol Evol ; 7(9): 1373-1378, 2023 09.
Article in English | MEDLINE | ID: mdl-37524796

ABSTRACT

Although eco-acoustic monitoring has the potential to deliver biodiversity insight on vast scales, existing analytical approaches behave unpredictably across studies. We collated 8,023 audio recordings with paired manual avifaunal point counts to investigate whether soundscapes could be used to monitor biodiversity across diverse ecosystems. We found that neither univariate indices nor machine learning models were predictive of species richness across datasets but soundscape change was consistently indicative of community change. Our findings indicate that there are no common features of biodiverse soundscapes and that soundscape monitoring should be used cautiously and in conjunction with more reliable in-person ecological surveys.


Subject(s)
Biodiversity , Ecosystem , Humans , Machine Learning
14.
Sex Transm Dis ; 50(7): 404-409, 2023 07 01.
Article in English | MEDLINE | ID: mdl-36943790

ABSTRACT

BACKGROUND: In the United States, annual screening for rectal gonorrhea and chlamydia is only recommended for men who report receptive anal sex (RAS), but other behaviors (e.g., rimming) may lead to rectal Chlamydia trachomatis and Neisseria gonorrhoeae acquisition. METHODS: We enrolled individuals assigned male sex at birth who reported sex with men and denied RAS in the past 2 years or reported RAS 1 to 2 years ago but were tested and treated since last RAS. Participants enrolled in-person at the Sexual Health Clinic in Seattle, Washington (December 2019-July 2022), or online (July 2021-March 2022). Participants completed a survey that asked about 13 non-RAS behaviors and self-collected a rectal swab for gonorrhea/chlamydia nucleic acid amplification testing. We used log binomial regression to estimate the prevalence of rectal gonorrhea/chlamydia (adjusted prevalence ratio [aPR]) by behavior, adjusting for all other behaviors. RESULTS: We enrolled 292 participants (247 in-person and 45 online); 277 (95%) had nucleic acid amplification testing results. Rectal gonorrhea/chlamydia test positivity was 14.1% overall: 10.5% for rectal chlamydia and 4.3% for rectal gonorrhea. Most participants (70%) reported ≥1 behavior that involved direct contact with their anus. We observed a higher risk of rectal chlamydia for those who did versus did not report perianal play at 12 months (aPR, 2.39; 95% confidence interval, 1.10-5.22) and 2 months (aPR, 2.21; 95% confidence interval, 1.02-4.79). This was the only behavior significantly associated with testing positive. CONCLUSIONS: Rectal C. trachomatis and N. gonorrhoeae prevalence was high among men who deny RAS, suggesting other possible routes of acquisition. Rectal screening for those who deny RAS should be made with careful consideration of individual- and population-level effects.


Subject(s)
Chlamydia Infections , Gonorrhea , Nucleic Acids , Rectal Diseases , Sexual and Gender Minorities , Infant, Newborn , Male , Humans , United States/epidemiology , Gonorrhea/diagnosis , Gonorrhea/epidemiology , Gonorrhea/prevention & control , Homosexuality, Male , Prevalence , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , Chlamydia Infections/prevention & control , Sexual Behavior , Neisseria gonorrhoeae/genetics , Chlamydia trachomatis , Rectal Diseases/epidemiology , Rectal Diseases/diagnosis
15.
Arch Sex Behav ; 52(2): 823-831, 2023 02.
Article in English | MEDLINE | ID: mdl-36459349

ABSTRACT

Modeling studies suggest that transmission of gonorrhea and chlamydia to multiple anatomic sites within the same person is necessary to reproduce observed high rates of extragenital gonorrhea/chlamydia. Limited empiric behavioral data support this idea. In this cross-sectional study, we enrolled individuals assigned male at birth who reported sex with men (MSM) and denied receptive anal sex (RAS) in the past 2 years. Participants enrolled in-person at the Sexual Health Clinic in Seattle, Washington (December 2019-September 2021) or online (July 2021-September 2021), and completed a sexual history questionnaire that asked about specific sexual acts and sequence of those acts during their last sexual encounter. We enrolled 210 MSM during the 16-month recruiting period. The median number of sex acts reported at last sexual encounter was 4 (interquartile range 3-5). The most commonly reported acts at last sex were: kissing (83%), receiving oral sex (82%), and insertive anal sex (65%). There was substantial variability in the sequence of acts reported; no unique sequence of sex acts was reported by more than 12% of the population. Ninety percent of participants reported sequences of behaviors that could lead to gonorrhea or chlamydia transmission within the same person (respondent or partner); the most common of these combinations was kissing followed by receiving oral sex (64% reporting). Engaging in multiple sex acts within a single sexual encounter is common and may lead to gonorrhea/chlamydia transmission within the same person. This complicates empiric measurements of transmission probabilities needed to estimate population-level transmission.


Subject(s)
Chlamydia Infections , Gonorrhea , HIV Infections , Sexual and Gender Minorities , Sexually Transmitted Diseases , Infant, Newborn , Male , Humans , Gonorrhea/epidemiology , Homosexuality, Male , Cross-Sectional Studies , Chlamydia Infections/epidemiology , Sexually Transmitted Diseases/epidemiology , Sexual Behavior , HIV Infections/epidemiology
16.
Sci Data ; 9(1): 755, 2022 12 07.
Article in English | MEDLINE | ID: mdl-36477373

ABSTRACT

Here we provide the 'Global Spectrum of Plant Form and Function Dataset', containing species mean values for six vascular plant traits. Together, these traits -plant height, stem specific density, leaf area, leaf mass per area, leaf nitrogen content per dry mass, and diaspore (seed or spore) mass - define the primary axes of variation in plant form and function. The dataset is based on ca. 1 million trait records received via the TRY database (representing ca. 2,500 original publications) and additional unpublished data. It provides 92,159 species mean values for the six traits, covering 46,047 species. The data are complemented by higher-level taxonomic classification and six categorical traits (woodiness, growth form, succulence, adaptation to terrestrial or aquatic habitats, nutrition type and leaf type). Data quality management is based on a probabilistic approach combined with comprehensive validation against expert knowledge and external information. Intense data acquisition and thorough quality control produced the largest and, to our knowledge, most accurate compilation of empirically observed vascular plant species mean traits to date.

17.
Environ Monit Assess ; 195(1): 70, 2022 Nov 04.
Article in English | MEDLINE | ID: mdl-36331679

ABSTRACT

Climate change is causing glaciers to retreat across much of the Himalaya, leading to a rapid shift of the vegetation cover to higher altitudes. However, the rate of vegetation shift with respect to glacier retreat, climate change, and topographic parameters is not empirically quantified. Using remote sensing measurements, we estimate (a) the rate of glacier-ice mass loss, (b) the upward vegetation line shift rate, (c) regional greening trends, and (d) a relationship between the factors influencing the greenness of the landscape and vegetation change in the Himalaya. We find that the glacier mass loss rate is 10.9 ± 1.2 Gt/yr and the mean vegetation line shifts upward in altitude by 7-28 ± 1.5 m/yr. Considering the land use/land cover change pattern, the grassland area is found to be expanding the most, particularly in the de-glaciated regions. The vegetation change is found to be controlled by soil moisture and slope of the area.


Subject(s)
Environmental Monitoring , Ice Cover , Environmental Monitoring/methods , Climate Change , Altitude
18.
BMJ Open ; 12(8): e056887, 2022 08 11.
Article in English | MEDLINE | ID: mdl-35953255

ABSTRACT

OBJECTIVES: Key populations, including sex workers, men who have sex with men, and people who inject drugs, have a high risk of HIV and sexually transmitted infections. We assessed the health and economic impacts of different HIV and syphilis testing strategies among three key populations in Viet Nam using a dual HIV/syphilis rapid diagnostic test (RDT). SETTING: We used the spectrum AIDS impact model to simulate the HIV epidemic in Viet Nam and evaluated five testing scenarios among key populations. We used a 15-year time horizon and a provider perspective for costs. PARTICIPANTS: We simulate the entire population of Viet Nam in the model. INTERVENTIONS: We modelled five testing scenarios among key populations: (1) annual testing with an HIV RDT, (2) annual testing with a dual RDT, (3) biannual testing using dual RDT and HIV RDT, (4) biannual testing using HIV RDT and (5) biannual testing using dual RDT. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome is incremental cost-effectiveness ratios. Secondary outcomes include HIV and syphilis cases. RESULTS: Annual testing using a dual HIV/syphilis RDT was cost-effective (US$10 per disability-adjusted life year (DALY)) and averted 3206 HIV cases and treated 27 727 syphilis cases compared with baseline over 15 years. Biannual testing using one dual test and one HIV RDT (US$1166 per DALY), or two dual tests (US$5672 per DALY) both averted an additional 875 HIV cases, although only the former scenario was cost-effective. Annual or biannual HIV testing using HIV RDTs and separate syphilis tests were more costly and less effective than using one or two dual RDTs. CONCLUSIONS: Annual HIV and syphilis testing using dual RDT among key populations is cost-effective in Vietnam and similar settings to reach global reduction goals for HIV and syphilis.


Subject(s)
HIV Infections , Sexual and Gender Minorities , Syphilis , Cost-Benefit Analysis , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Testing , Homosexuality, Male , Humans , Male , Syphilis/diagnosis , Syphilis/epidemiology , Vietnam/epidemiology
19.
Nat Ecol Evol ; 6(10): 1423-1437, 2022 10.
Article in English | MEDLINE | ID: mdl-35941205

ABSTRACT

The latitudinal diversity gradient (LDG) is one of the most recognized global patterns of species richness exhibited across a wide range of taxa. Numerous hypotheses have been proposed in the past two centuries to explain LDG, but rigorous tests of the drivers of LDGs have been limited by a lack of high-quality global species richness data. Here we produce a high-resolution (0.025° × 0.025°) map of local tree species richness using a global forest inventory database with individual tree information and local biophysical characteristics from ~1.3 million sample plots. We then quantify drivers of local tree species richness patterns across latitudes. Generally, annual mean temperature was a dominant predictor of tree species richness, which is most consistent with the metabolic theory of biodiversity (MTB). However, MTB underestimated LDG in the tropics, where high species richness was also moderated by topographic, soil and anthropogenic factors operating at local scales. Given that local landscape variables operate synergistically with bioclimatic factors in shaping the global LDG pattern, we suggest that MTB be extended to account for co-limitation by subordinate drivers.


Subject(s)
Biodiversity , Forests , Soil , Trees
20.
Conserv Biol ; 36(6): e13970, 2022 12.
Article in English | MEDLINE | ID: mdl-35713105

ABSTRACT

Reducing emissions from deforestation and forest degradation (REDD+) projects aim to contribute to climate change mitigation by protecting and enhancing carbon stocks in tropical forests, but there have been no systematic global evaluations of their impact. We used a new data set for tropical humid forests and a standardized evaluation approach (based on pixel matching) to quantify the performance of a representative sample of 40 voluntary REDD+ projects in 9 countries certified under the Verified Carbon Standard (VCS). In the first 5 years of implementation, deforestation within project areas was reduced by 47% (95% confidence interval [CI]: 24-68) compared with matched counterfactual pixels, and degradation rates were 58% lower (95% CI: 49-63). Reductions were small in absolute terms but greater in sites located in high-deforestation settings and did not appear to be substantially undermined by leakage activities in forested areas within 10 km of project boundaries. At the 26th Conference of the Parties of the United Nations Framework Convention on Climate Change, the international community renewed its commitment to tackling tropical deforestation as a nature-based solution to climate change. Our results indicate that incentivizing forest conservation through voluntary site-based projects can slow tropical deforestation and highlight the particular importance of prioritizing financing for areas at greater risk of deforestation.


Evaluación Global de la Efectividad de proyectos REDD+ en la Reducción de la Deforestación y Degradación en el Trópico Húmedo Resumen Los proyectos para la reducción de emisiones derivados de la deforestación y degradación de bosques (REDD+) tienen como meta contribuir a la mitigación del cambio climático al protejer y  fomentar la disponibilidad de carbono en bosques tropicales, pero a la fecha no se han realizado evaluaciones globales sistemáticas sobre su impacto. Utilizamos bases de datos recientes sobre bosques tropicales húmedos y un método estandarizado de evaluación (basado en 'emparejamiento' [matching] de pixeles) para cuantificar el desempeño de una muestra representativa de 40 proyectos voluntarios REDD+ , localizados en 9 países y certificados bajo el estándar Verified Carbon Standard (VCS). En los primeros 5 años de implementación, la deforestación en las áreas de los proyectos disminuyó en 47% (IC 95% 24-68) en comparación con los pixeles contrafactuales correspondientes, y las tasas de degradación fueron 58% menos (IC 95% 49-63). Las reducciones fueron pequeñas en términos absolutos pero mayores en sitios con tasas de deforestación elevadas, y no parecieron ser afectadas sustancialmente por efectos de fuga (leakage) en áreas boscosas en un radio de 10 km de los límites del proyecto. En la COP26, la comunidad internacional renovó su compromiso de afrontar la deforestación tropical como una solución al cambio climático basada en la naturaleza. Nuestros resultados indican que incentivar la conservación de bosques mediante proyectos locales voluntarios puede disminuir la deforestación tropical, y resaltan la importancia de priorizar financiamiento en áreas con un mayor riesgo de deforestación.


Subject(s)
Conservation of Natural Resources , Forests , Climate Change , Carbon
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